title: Birth outcomes of planned home births in Missouri: a population-based study.
abstract: We evaluated the birth outcomes of planned home births. We conducted a retrospective cohort study using Missouri vital records from 1989 to 2005 to compare the risk of newborn seizure and intrapartum fetal death in planned home births attended by physicians/certified nurse midwives (CNMs) or non-CNMs with hospitals/birthing center births. The study sample included singleton pregnancies between 36 and 44 weeks of gestation without major congenital anomalies or breech presentation ( N = 859,873). The adjusted odds ratio (aOR) of newborn seizures in planned home births attended by non-CNMs was 5.11 (95% confidence interval [CI]: 2.52, 10.37) compared with deliveries by physicians/CNMs in hospitals/birthing centers. For intrapartum fetal death, aORs were 11.24 (95% CI: 1.43, 88.29), and 20.33 (95% CI: 4.98, 83.07) in planned home births attended by non-CNMs and by physicians/CNMs, respectively, compared with births in hospitals/birthing centers. Planned home births are associated with increased likelihood of adverse birth outcomes.
authors.affiliation: Department of Community Health in Epidemiology, Saint Louis University School of Public Health, 3545 Lafayette Avenue, St. Louis, MO 63194, USA. changdalton@gmail.com
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.forename: George A
authors.initials: GA
authors.lastname: Macones
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005323:Fetal Monitoring / Q000706:statistics & numerical data; D006700:Home Childbirth; D006801:Humans; D007751:Labor, Induced / Q000706:statistics & numerical data; D016015:Logistic Models; D008923:Missouri; D009721:Nurse Midwives; D007744:Obstetric Labor Complications / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology; D055815:Young Adult